ST-segment changes during tilt table testing for postural tachycardia syndrome: correlation with exercise stress test results

Background Prior studies have reported ECG (Electrocardiogram) changes during tilt table testing (TTT), specifically during repolarization with ST-segment and T-wave changes. The correlation with ischemic evaluation remains unclear. The purpose of this study was to analyze the prevalence of ST-segme...

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Bibliographic Details
Published in:Clinical autonomic research 2020-02, Vol.30 (1), p.79-83
Main Authors: Vajapey, Ramya, Hutt Centeno, Erika, Van Iterson, Erik H., Ahmed, Haitham M., Mayuga, Kenneth A.
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
Cardiology
Diabetes
EKG
Electrocardiography
Endocrinology
Gastroenterology
Ischemia
Medicine
Medicine & Public Health
Neurology
Ophthalmology
Posture
Short Communication
Tachycardia
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Summary:Background Prior studies have reported ECG (Electrocardiogram) changes during tilt table testing (TTT), specifically during repolarization with ST-segment and T-wave changes. The correlation with ischemic evaluation remains unclear. The purpose of this study was to analyze the prevalence of ST-segment changes during TTT in a young, otherwise healthy population of patients with postural tachycardia syndrome (POTS), and correlate them with exercise stress test results. Methods Two hundred and fifty-five patients with POTS who underwent TTT and an exercise treadmill test (ETT) were analyzed. Results Forty-five had ST-segment changes/depressions during TTT (91% female, average age 36 years). Of the 45, three had ST-segment depression during ETT; all three had negative exercise stress echocardiograms (ESEs). Two others had ST-segment depressions on ETT (but not TTT), with negative ESEs. Conclusion In a cohort of young, female, otherwise healthy patients with POTS, ST-segment changes occurred in a significant portion (18%) of patients during TTT. When evaluated with exercise stress testing, these patients had no evidence of underlying ischemia on ETT or ESE.
ISSN:0959-9851
1619-1560
DOI:10.1007/s10286-019-00633-9